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Article
Publication date: 2 January 2018

Enrico Maria Piras

The paper reflects on the role of knowledge artefacts in the patient-provider relationship across the organisational boundaries of the clinical setting. Drawing on the…

Abstract

Purpose

The paper reflects on the role of knowledge artefacts in the patient-provider relationship across the organisational boundaries of the clinical setting. Drawing on the analysis of the diabetes logbook, the purpose of this paper is to illustrate the role of knowledge artefacts in a fragmented system of knowledge through the study of two distinct practices: “logbook compiling” and “consultation in the surgery”.

Design/methodology/approach

The theoretical framework of analysis is rooted in the tradition of practice-based studies which envisions knowledge as the emerging, precarious and socially constructed product of being involved in a practice. The paper follows a designed qualitative research, conducting semi-structured interviews, participant observation and artefact analysis.

Findings

The knowledge artefacts support different and partially irreducible forms of knowledge. Knowing-in-practice is accomplished by means of different activities which contribute to the reshaping of the knowledge artefact itself. The analysis of the “knowledge artefact-in-use” reveals that different actors (doctors and patients) adopt two different perspectives when investigating the chronic condition. Clinicians are interested in a chronological representation of patient data while patients and families are interested in making sense of specific situations, adopting a kairotic perspective (Kairos: the right moment) that emphasises the instant in which something significant for someone happens.

Originality/value

The analysis of the knowledge artefacts-in-use has a twofold outcome. On one hand, it illustrates the mutual shaping of knowing, artefacts and practices. On the other hand, it shows how knowledge artefact can become pivotal resources in a fragmented system of knowledge.

Details

Data Technologies and Applications, vol. 52 no. 1
Type: Research Article
ISSN: 2514-9288

Keywords

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Article
Publication date: 28 October 2014

Enrico Maria Piras and Alberto Zanutto

Personal Health Record (PHR) systems make possible to integrate data from different sources and circulate them within the illness care and management network. The new…

Abstract

Purpose

Personal Health Record (PHR) systems make possible to integrate data from different sources and circulate them within the illness care and management network. The new arrangements prefigure a redefinition of the relations among healthcare practitioners, patients, and caregivers. The purpose of this paper is to consider the role and the meanings attributed to information when a technical artifact enables new forms of communication within the healthcare management network.

Design/methodology/approach

The authors adopted a qualitative research design, conducting a pre-post analysis on a theoretical sample of patients and of a paediatrics department. The authors selected 12 patients (six females and six males) aged between four and 20 years old.

Findings

The patients were willing to act as “stewards of their own information” (Halamka et al., 2008), but they interpreted this role in terms of restricting access to their information, rather than facilitating its dissemination. In fact, the PHR was symbolized as an instrument to support personal diabetes management but the patients want to preserve their own competence and independent management on the information regarding their “Personal” diseases.

Originality/value

This work highlights two connotation of “Personal” information. The first is the dimension of the right to the privacy of information when it is believed that it may be used to pass judgement on the patient. The second connotation of “Personal” is the assertion by patients of their competence and autonomy in interpreting the information on the basis of personal knowledge about their diabetes.

Details

Information Technology & People, vol. 27 no. 4
Type: Research Article
ISSN: 0959-3845

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Article
Publication date: 6 June 2016

David Forbes and Pornpit Wongthongtham

There is an increasing interest in using information and communication technologies to support health services. But the adoption and development of even basic ICT…

Abstract

Purpose

There is an increasing interest in using information and communication technologies to support health services. But the adoption and development of even basic ICT communications services in many health services is limited, leaving enormous gaps in the broad understanding of its role in health care delivery. The purpose of this paper is to address a specific (intercultural) area of healthcare communications consumer disadvantage; and it examines the potential for ICT exploitation through the lens of a conceptual framework. The opportunity to pursue a new solutions pathway has been amplified in recent times through the development of computer-based ontologies and the resultant knowledge from ontologist activity and consequential research publishing.

Design/methodology/approach

A specific intercultural area of patient disadvantage arises from variations in meaning and understanding of patient and clinician words, phrases and non-verbal expression. Collection and localization of data concepts, their attributes and individual instances were gathered from an Aboriginal trainee nurse focus group and from a qualitative gap analysis (QGA) of 130 criteria-selected sources of literature. These concepts, their relationships and semantic interpretations populate the computer ontology. The ontology mapping involves two domains, namely, Aboriginal English (AE) and Type II diabetes care guidelines. This is preparatory to development of the Patient Practitioner Assistive Communications (PPAC) system for Aboriginal rural and remote patient primary care.

Findings

The combined QGA and focus group output reported has served to illustrate the call for three important drivers of change. First, there is no evidence to contradict the hypothesis that patient-practitioner interview encounters for many Australian Aboriginal patients and wellbeing outcomes are unsatisfactory at best. Second, there is a potent need for cultural competence knowledge and practice uptake on the part of health care providers; and third, the key contributory component to determine success or failures within healthcare for ethnic minorities is communication. Communication, however, can only be of value in health care if in practice it supports shared cognition; and mutual cognition is rarely achievable when biopsychosocial and other cultural worldview differences go unchallenged.

Research limitations/implications

There has been no direct engagement with remote Aboriginal communities in this work to date. The authors have initially been able to rely upon a cohort of both Indigenous and non-Indigenous people with relevant cultural expertise and extended family relationships. Among these advisers are health care practitioners, academics, trainers, Aboriginal education researchers and workshop attendees. It must therefore be acknowledged that as is the case with the QGA, the majority of the concept data is from third parties. The authors have also discovered that urban influences and cultural sensitivities tend to reduce the extent of, and opportunity to, witness AE usage, thereby limiting the ability to capture more examples of code-switching. Although the PPAC system concept is qualitatively well developed, pending future work planned for rural and remote community engagement the authors presently regard the work as mostly allied to a hypothesis on ontology-driven communications. The concept data population of the AE home talk/health talk ontology has not yet reached a quantitative critical mass to justify application design model engineering and real-world testing.

Originality/value

Computer ontologies avail us of the opportunity to use assistive communications technology applications as a dynamic support system to elevate the pragmatic experience of health care consultations for both patients and practitioners. The human-machine interactive development and use of such applications is required just to keep pace with increasing demand for healthcare and the growing health knowledge transfer environment. In an age when the worldwide web, communications devices and social media avail us of opportunities to confront the barriers described the authors have begun the first construction of a merged schema for two domains that already have a seemingly intractable negative connection. Through the ontology discipline of building syntactically and semantically robust and accessible concepts; explicit conceptual relationships; and annotative context-oriented guidance; the authors are working towards addressing health literacy and wellbeing outcome deficiencies of benefit to the broader communities of disadvantage patients.

Details

Information Technology & People, vol. 29 no. 2
Type: Research Article
ISSN: 0959-3845

Keywords

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